Concentrated disadvantage and functional disability: a longitudinal neighbourhood analysis in 100 US cities.

BACKGROUND: Socioeconomic disadvantage related to poverty, unemployment and social disinvestment contributes to significant disparities in community health in the USA. Yet, there remains limited ecological research on the relationship between neighbourhood disadvantage and functional disability. Much of the work in this area has focused on elderly populations without attention to variation across age and sex groups. METHODS: Using a longitudinal dataset of almost 16 000 neighbourhoods, we examine the relationship between neighbourhood disadvantage and functional disability. Leveraging a series of cross-lagged panel models, we account for reciprocal dynamics and a range of pertinent covariates while assessing differences across age- and sex-specific groups. RESULTS: Accounting for reciprocal effects, we found that the association between concentrated disadvantage and functional disability varies across age and sex groups. Concentrated disadvantage is most consistently associated with increased functional disability among boys (5-17 years), young men (18-34 years) and middle-aged men (35-64 years). Similar associations are found among girls (5-17 years) and middle-aged women (35-64 years). CONCLUSION: Local neighbourhood economic conditions are significantly associated with functional disability among relatively young populations of males and females. Exposure to neighbourhood disadvantage and deprivation may accelerate disablement processes and shift the age curve of disability risk.